Evidence prevails: No medical marijuana for autism in Michigan—for now

oracknows — Fri, 28 Aug 2015 06:30:46 +0000

I must admit that I'm surprised. Pleasantly surprised, but quite surprised. The reason is that yesterday the Department of Licensing and Regulatory Affairs Director Mike Zimmer rejected the recommendation of the Michigan Medical Marijuana Review Panel to add autism to the list of qualifying conditions for which cannabis can be prescribed in the state of Michigan. I didn't expect this outcome, but I am pleased.

Although I've changed my mind over past stands and am now in favor of legalizing marijuana for recreational use, I have been harshly critical of the "medical marijuana" movement. Indeed, I have referred to it as the "new herbalism" because when it comes to evidence for the efficacy of marijuana in the myriad conditions that cannabis is claimed to be able to treat, its proponents' hype far outweighs the actual medical promise, at least when you look at the evidence objectively. As I've pointed out before, for example, cannabis does not cure cancer, passionate testimonials otherwise notwithstanding, and the state of the evidence supporting the use of medical marijuana for almost anything is, at best, weak and contradictory. That's not to say that cannabinoids, the active compounds in cannabis, don't have some medical uses, but, again, a dispassionate look at the medical literature suggests that the hype far exceeds any realistic promise.

Three weeks ago, I wrote a post likening the use of "medical marijuana" for autism to a form of quackery that I have written about many times over the years, namely so-called "autism biomed." As I mentioned, a certain segment of the "autism biomed" movement has enthusiastically embraced medical cannabis, to be added to the other dubious treatments used to "treat" autism, such as chelation therapy, various supplements, hyperbaric oxygen, homeopathy, Miracle Mineral Solution (MMS, a.k.a. a form of bleach), and the like. (I'm talking to you, "Thinking Moms.") As I detailed in that post, the parallels are unmistakable. In the case of cannabis for autism, there is the same evangelical embrace of cannabis as the next big thing that can help autistic children and the same dismissal of the extreme lack of evidence supporting the use of medical cannabis for autism and the lack of knowledge of the effect of long term cannabis use in very young children on their neurological development. Remember, we're talking about children as young as three years old here and the use of cannabis over potentially many years.

Three weeks ago, I was concerned that the Michigan Medical Marijuana Review Panel, an advisory panel that makes recommendations to the Michigan Department of Community Health regarding what conditions qualify for medical marijuana use, had voted 4-2 in favor of adding autism to the list of qualifying conditions for medical marijuana, specifically in this case cannabis oil, can be prescribed. The panel was apparently impressed by some very dubious evidence and testimony, specifically a paper by Joe Stone and Dr. Christian Bogner, "The Endocannabinoid System as it Relates to Autism." Basically, this "paper' was not peer-reviewed or published anywhere reputable. More importantly (given that blog posts and articles, when referenced and written properly, can be quite compelling from a scientific standpoint), the article cherry picked studies and massively oversold weak preclinical results in cell culture and animal studies. The panel appeared also to be particularly impressed by the testimony of Dr. Harry T. Chugani, the head of pediatric neurology at Children’s Hospital of Michigan, who, despite the lack of evidence, has apparently become convinced on the basis of testimonials and personal observation despite the lack of anything resembling rigorous scientific and clinical evidence that cannabis is an effective treatment against autism.

Kudos to Mike Zimmer for seeing through the flimsiness of the evidence and not being blinded by eminence when evaluating Dr. Chugani's testimony:

Department of Licensing and Regulatory Affairs Director Mike Zimmer, in a final determination released Thursday, cited a "concerning" lack of scientific evidence regarding medical marijuana use by autistic patients, specifically by children.

"While the record is replete with sincere and well-articulated testimony on the potential benefits of medical marihuana to autism patients and, in particular, parents of autistic children, several troubling concerns remain," he wrote.

Reading the final determination, I was impressed at how Zimmer saw through the tactics of the medical marijuana movement. First, he noted the overbroadness of the petition to add autism as to the conditions that qualify for medical cannabis:

The petition under consideration lists "autism" without limitation as the medical condition proposed for inclusion as a qualifying condition under the MMMA [Michigan Medical Marijuana Act]. Although "severe autism" is referenced in the petition, the petition does not limit the proposed qualifying medical condition to "severe autism," nor is the term "severe autism" defined anywhere in the petition. Thus the petition seeks to add autism without limitation as a qualifying condition under the MMMA.

Nice catch there. Advocates of medical marijuana frequently go beyond what the scientific evidence will support and seek the broadest possible indications for the use of their favorite weed (or extracts thereof). Here's another good catch:

In the justification section of the petition, the petitioner indicates that "medical marijuana has been used successfully in Michigan to treat the syptoms of severe autism in patients who also suffer from epilepsy." (emphasis added). It is, therefore, important to examine the petition's illustrative linking in the justification section to epilepsy. In fact, many of the parents who participated in the public hearing indicated that their severely autistic children suffered seizures as a result of that condition. An examination of the language in the MMMA, however, establishes that these may already be eligible.

Of course, as I've noted before, the evidence that cannabis is useful for epilepsy is also pretty weak, but it is—shall we say?—considerably less weak than the evidence supporting medical cannabis for autism.

Noting that the MMMA explicitly allows the use of medical marijuana for seizures and citing the appropriate section of the law, Zimmer goes on to state that "our discussion on this petition is focused on autistic patients without associated seizure disorders" and then does just that, citing how the state's Chief Medical Executive Eden Wells had "bemoaned that there were not more clinical trials to provide checks and balances on the benefits versus its possible ill-effects." He even cited Dr. Chugani himself, noting that he "would not support a general recommendation for cannabis to treat all children with autism, as little scientific evidence exist to demonstrate gains in skill acquisition and research is still needed to assure children would not suffer short or long term psychotropic effects.

Zimmer also saw through the petition's claim that requiring two doctors to sign off on prescriptions for medical marijuana for autism would protect children:

At public hearing, several suggested that the lack of scientific supportive research could be offset by strict certification practices by a patient's physician. Mr. Michael Komorn, an attorney for the petitioner and ardent advocate, stated that under current law, two doctors must sign off on approval for the use of medical marihuana by minors and that "obviously in the case of minors these doctors will likely be their doctors, their autism specialist (5/27/15 Hrg. Tr., p. 17)." Similarly, Dr. Harry Chugani, in his letter to the panel, stated that "I also highly recommend that determinations of which patients may be appropriate should be made strictly by a highly skilled, experienced medical doctor, with significant experience in treating autism." Unfortunately, there is no such requirement in the MMMA. MCL 333.26426(b)(2) simply requires written certifications from two physicians and does not contain any requirement that those physicians be expert, comply with certification practices, or even be trained in the treatment of autism."

But, then, many of the advocates who promoted this petition probably already knew that. Basically, any physician who wants to can prescribe medical marijuana, no special training or expertise necessary. That's the way the law was written, and intentionally so. Ironically, Zimmerman also noted that the way the law has been written and interpreted by Michigan courts almost certainly precludes the use of cannabis oil because it probably does not fall under the definition of "usable marihana" outlined in the MMMA, but cannabis oil is what the petition was for.

Medical marijuana has always been a blatant back door strategy to legalize marijuana for recreational use, so much so that most advocates don't even bother to deny it. While I support legalization of marijuana, I do not support the corruption of medicine and medical evidence inherent in the claims of the medical marijuana movement. In other words, I do not support the loosening of the standards of medical evidence that is required to justify widespread medical cannabis use for conditions for which there is little or no evidence of efficacy. When it comes to cannabis, preclinical evidence is routinely touted as indicating clinical efficacy, and studies are blatantly cherry picked to justify its use. Worse, poor quality evidence that, if used to support the approval of a pharmaceutical drug, would provoke justified howls of outrage from the very same people advocating medical marijuana for autism, is touted as convincing scientific evidence that autism should be added to the list of qualifying conditions for medical marijuana. As always, I advocate for one standard of medical evidence. Unfortunately, advocates of medical cannabis, like advocates of "complementary and alternative medicine" (who not infrequently include the same people), advocate for a weaker standard of evidence for their favorite herb.

If you don't believe this is far more about advancing an agenda leading to legalization, witness the reactions to the decision by advocates, for example, of Robin Schneider:

Zimmer’s order also said there was insufficient scientific research to justify using cannabis for autism. That’s a concern about many of the conditions that are clearly aided by the drug, since marijuana research has been largely illegal to conduct under state and federal drug laws, said Robin Schneider, a spokeswoman for the National Patients Rights Association, a medical-marijuana advocacy group based in Grosse Pointe Farms.

“But in this circumstance, the petitioner did an incredible job of putting together a great deal of scientific information,” Schneider said. The petitioner was Lisa Smith of Van Buren Township, mother of Noah, a 6-year-old boy with autism.

Of course, if it is true that cannabis research has been made very difficult by drug laws, the correct order of business would be to work on repealing those drug laws to allow the research to proceed. Advocates instead just assume that medical marijuana "works" and then cherry pick the evidence to try to support that assumption, ignoring its extreme lack of quantity and quality.

Elsewhere:

"I'm disappointed and I'm frustrated. I think that obviously he used a lot of words to explain an inconsistent and subjective decision in opposing the panel's recommendation," said Komorn.

The goal of the petition was to extend legal protections of the medical marijuana law to parents who want to treat their autistic children, he said.

"If these parents know or believe that it's working, they're going to do it," he said. "We're asking them to be removed from the battle field of the losing war on marijuana."

This is a ridiculous argument, even coming from Komorn, but very telling. For one thing, Zimmer's decision was far clearer and more consistent than any argument I've heard from Komorn in support of medical marijuana for autism. More tellingly, Komorn doesn't appear to care much whether medical marijuana has any beneficial effect whatsoever in severe autism. The "tell" is how he just can't help himself and has to justify his argument by referencing the "losing war on marijuana." To Komorn, fighting for medical marijuana for autism is simply a a tactic in the larger war to legalize marijuana, nothing more. From my perspective, he doesn't really care that much about autistic children and their parents, per se. Rather, he sees them as weapons to use in his wider war.

Let's just put it this way. His argument is that parents are going to use marijuana for their autistic children anyway; so he wants to "make it legal," so to speak. I wonder if he'd accept the same argument for MMS enemas (a.k.a. bleach enemas) for autistic children. Some parents are going to subject their children to this treatment anyway. It's a ridiculous argument unless, as Komorn does for medical marijuana for autism, you were to see MMS as a battle in a wider war. I've seldom seen such a blunt, bald-faced admission that the main reason for medical marijuana is as a means of legalizing recreational use of marijuana. Sure, he didn't say that, exactly, but taken in context his meaning is clear. Medical marijuana for autism is a battle in a wider war.

Collateral damage in this war includes parents like Dwight Zahringer, whom we met before the last time I discussed this topic. He only wants to do what's best for his son Brunello and, because of the hype, has come to believe that medical marijuana is what his son needs to help him. Consequently, he joined the movement to add autism to the list of qualifying conditions, and he is very disappointed in this ruling:

“I’m going to have to keep looking at more treatment options and to be part of the movement to educate these people in Lansing,” Dwight Zahringer said.

“I feel like we’ve had a lot of politics involved in decisions like this,” Zahringer said.

Zahringer is correct, but not in the way he thinks. It was a ton of politics to twist the thin evidence for marijuana into a petition that got through the Michigan Medical Marijuana Panel by a 4-2 vote. Now that it's been rejected, he understandably feels betrayed, as though a major source of hope for his son has been taken from him.

Unfortunately, I doubt that this is the end of the story. I have little doubt that advocates like Komorn will be back. It Zimmer rejected this petition because it is too broad, expect advocates to be back in the near future with a more carefully crafted petition this more narrowly defines "severe autism."

oracknows Fri, 08/28/2015 - 02:30

Categories

Medicine

What seems to be a defining feature of a lot of marijuana users is the ability to spontaneously delete information in their brain that isn't in accordance with their ideas.
You could have a long debate with them that ends up with them not knowing what to say or saying: "well, it's just something that I've read somewhere". But then, a month later they would start the debate again at exactly the same place they started it the first time, as if your previous conversation never happenned.
They also seem to think that everything is better with marijuana, and that they are better at everything while under the influence of marijuana. Wouldn't surprise me if the vast majority of those advocating for the treatment of autism with marijuana are heavy users themselves.
Yeah, I don't think we've seen the last of them.

Cheers and Hoorays for Mr (Dr?) Zimmer!

It's hard enough constantly refuting the claims of "complementary" medicine and "too many too soon"; now we are bombarded with a slew of anecdotes and the "lack of research because it's illegal" rot. It's good to have a solid decision to stop this back door strategy to legalize pot.

I fear you are correct that this won't be the end of it, however. In the meantime, I shall bask in one small victory for science.

I was dismayed reading the comments. There too is the only concern getting marijuana legalised. There was almost no consideration for the children who would be and are subjected to cannabis oil.

Yeah, I forgot to mention the comments. They are depressing.

What seems to be a defining feature of a lot of marijuana users is the ability to spontaneously delete information in their brain that isn’t in accordance with their ideas.

That's hardly unique to marijuana users. There is this Canadian MP named Harper, and several like-minded politicians this side of the border, who are not known to partake of C. sativa. Closer to topic, you have anti-vaccination activists who insist mercury (which has not been in childhood vaccines for more than a decade) causes autism, homeopaths who ignore the finite value of Avogadro's number, et cetera.

It's true that we stereotypically associate marijuana use and delusional beliefs ("What is he smoking, and where do I get some?"). Paranoia is a known side effect in some users. But just because you're paranoid doesn't mean they aren't out to get you, and conversely, lots of people suffer from delusions without any help from marijuana.

It’s good to have a solid decision to stop this back door strategy to legalize pot.

I'm personally of the opinion that marijuana should be legal, subject to the same sorts of restrictions that apply to alcohol and tobacco. But I agree that if we are going to legalize it, we should be up front about legalizing it, and not go down the rabbit hole of using it to treat conditions for which there is no evidence of efficacy.

Garou: "They also seem to think that everything is better with marijuana".
I don't know about everything, but White Castle and Pizza Hut sure are.

Rimshot!

Science Mom says,

...almost no consideration for children who would be and are subjected to cannabis oil.

MJD says,

Adults with autism, if you have experienced marijuana what are your thoughts about giving such a material to autistic children?

Old Rockin' Dave -- And "In a Gadda da Vida".

"Marge, remember when we used to make out to this hymn?"

One... (something, something)... over the line...

There is a wonderful and hilarious video of this "modern spiritual" being performed on The Lawrence freaking Welk Show, just by the by.

@palindrom: Hey, this sounds like rock and/or roll!

@Old Rockin' Dave
#6
"Have you seen the back of a 20 dollar bill?"....."Have you seen the back of a 20 dollar bill.....on weed?"

jonnybdead,

Ha! I was just looking up YouTube vids of the very same thing. Wanted to get the complete 'different kinds of smokers' but was only able to find individual ones and they're still a bit long.

Per your reference https://www.youtube.com/watch?v=hkA9rz-1YoA

The movie is as corny as the day is long but it's one of my favorites.

I suppose methylphenidate is on the approved list for autistics demonstrating ADHD? How does Ritalin work, anyway; Take an already hyper-stimulated mind and push it over the edge?

as little scientific evidence exist to demonstrate gains in skill acquisition and research is still needed to assure children would not suffer short or long term psychotropic effects.

Well, maybe someone should just ask the kids how they *feel*. Perhaps it is time to evaluate the benifits of cannabis over Ritalin et al. for ADHD, in general.

Naa, ^^ that wouldn't be prudent or so lucrative.

Perhaps it is time to evaluate the benifits [sic] of cannabis over Ritalin et al. for ADHD

That would be the way to provide evidence that it's effective. Can you show that it's plausible that cannabis can treat ADHD? Enough to show to an IRB?

Broken link Orac.
Link to cannabis for autism blog is broken.

There was a study on ADHD and crime.
Found double the crime rate. Half of the crime was for possession of illegal versions of ADHD meds,. Go figure.

"demonstrate gains in skill acquisition"

And this is relevant to cannabis/autistics how? In such a rigid, pigeonholed society, I suppose one may be deprived of learning the skill of repackaging old lightbulbs for the phone-solicitation resellers, should they fail to please the piss-testers.

How does Ritalin work, anyway; Take an already hyper-stimulated mind and push it over the edge?

Gee, it's not like it takes all of two minutes to find a starting place. What does this have to do with the post at hand, again?

Magnets - how do they work?

@14:

I suppose methylphenidate is on the approved list for autistics demonstrating ADHD? How does Ritalin work, anyway; Take an already hyper-stimulated mind and push it over the edge?

An extremely oversimplified version is "Ritalin boosts dopamine levels, dopamine makes it easier to pay attention". This ignores other factors at play, admittedly, but it's a pretty important one regardless.

OK, Narad.

So; take a full-on revvin' mind and stall it by leaning it out; starving it of the proper ratios of neurotransmitters ( by exausting stores glucose... demand>>>supply altogether????)-- When I do this to the chainsaw, it burns holes in the piston.

So; take a full-on revvin’ mind and stall it by leaning it out; starving it of the proper ratios of neurotransmitters ( by exausting stores glucose… demand>>>supply altogether????)– When I do this to the chainsaw, it burns holes in the piston.

You can lead a horse to water, but you can't make him wash his armpits.

@ MJD #8: As an adult with Asperger's, my view on it is very dim. Basically the parents want to dope up their kids to eliminate behaviors in autistic children than are difficult to deal with.

Panacea: As another, I agree with you. If they hadn't latched on to marijuana, they would probably be looking at barbiturates or benzodiazepines. Anything not to engage with their less-than-perfect child whose very existence fills them with shame. Pump them full of the latest quackery so they can pretend they really care and are "doing everything" for the kid they really want to lock up in the attic.

@Panacea, it's lucky for you that adults like me are here to tell you that you're wrong. I have asperger's too. My view on your attitude is very bright.

It seems to me that there are a lot of generalizations being made, and not enough looking at research going on here. I am reading a lot of opinions on ADD/ADHD is. As well as (im no neurologist but here is my opinion that is backed by whatever i have made up in my head.)

just because you dont know how the drugs work does not mean they are all bad. or perhaps you have a better solution based in science?

There was a study on ADHD and crime.
Found double the crime rate. Half of the crime was for possession of illegal versions of ADHD meds,. Go figure.

"Go figure" what? Why someone would be so mentally lazy as to idly expect other people to dig up random disgorgements?

Gilbert @14: As a person with ADHD, I know that I feel better on my medications than off (I don't take Ritalin or Adderal). I've never had pot because it only recently became legal and I still don't know if consuming it could get me fired.

My medications have never made me feel like a 'zombie', but having watched some stoned people, I'm afraid that it what pot would make me feel like.

Esther, you just contradicted yourself. Do you agree with me or not?

jonnybedead: ADHD sometimes goes hand in hand with autism, at least on the higher end of the spectrum, to a mild level that often doesn't require medication, so the comparison really isn't that far off.

http://www.ncbi.nlm.nih.gov/pubmed/7413719
yeah small sample size i agree.

http://www.cifas.us/sites/cifas.drupalgardens.com/files/1988_NewbornOut…
http://www.ncbi.nlm.nih.gov/pubmed/1957518
pfft jamaica.

http://www.ncbi.nlm.nih.gov/pubmed/22350104
yeah yeah...

you asked about pica and cannabis in a previous comment, i remembered reading one parents' anecdotal evidence of treating their autistic child with cannabis.

http://www.slate.com/articles/double_x/doublex/2011/05/why_i_give_my_au…
"The pica that had him literally eating clothing, and which plagued and worried us for so long, stopped completely after his first dose of cannabis, though no one seems to understand why."

herbalism? i guess broccoli is not a herb...
http://www.ncbi.nlm.nih.gov/pubmed/20388854
https://clinicaltrials.nlm.nih.gov/ct2/show/NCT01753908
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4059031/
http://www.ncbi.nlm.nih.gov/pubmed/17516858
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2579766/
eat your broccoli raw, kids!

IDK, Leo T. From Narad's link:

Either direct or indirect attenuation of dopamine and norepinephrine neurotransmission

http://www.ncbi.nlm.nih.gov/pubmed/16961428

On second thought, don't ask the kids how they feel. Don't dare risk discovery or dwell on the fact that *getting a grin, again and again* is not scientific and deserves penitentiary max.

Some politicians and lawmakers would rather destroy the lives of children than stand up to their corporate masters. Cannabis legalization is just another crystal clear example of how our lawmakers bend over for corporations.

Tobacco, alcohol and pharmaceutical drug companies make 100s of billions in profit every year. Our politicians take their money, do their bidding, and so it goes. Corporations who are scared witless of losing their long term deadly stranglehold on the US public due to cannabis legalization. Massive citizen outcry is required to make this gigantic lie right.

All the information to make an informed decision about cannabis legalization has been at the Center for Disease Control for decades . Data from the US Center for Disease Control supports cannabis legalization. It is absolutely clear that cannabis is safer than the legal serial killers tobacco, alcohol and pharmaceutical drugs which kill over 650,000 US citizens annually. Nothing the least bit complicated or hard to understand about these statistics taken directly from the CDC dot gov web site:

Numbers of deaths per year in the USA
* Prescription Drugs: 237,485 + 5,000 traffic fatalities
* Tobacco: 390,323
* Alcohol: 88,013 + 16,000 traffic fatalities
* Cocaine: 4,906
* Heroin: 3,365
* Aspirin: 466
* Acetaminophen (Tylenol): 179
* Marijuana: 0, none, not a single fatal toxic overdose in all medical history and almost no traffic problems

So, which is safer?

Legalize, regulate and TAX!

NO Panacea I do not agree with you.
Nor do I agree with your guesswork.
Nor do I agree that simply having asperger's gives you any more credibility than a radish.

http://www.ncbi.nlm.nih.gov/pubmed/26282273
Neurotherapeutics. 2015 Aug 18.
"Cannabinoids and Epilepsy."

My university only has a subscription to that journal up to a year ago; so I cannot look it up. The abstract, however, does not suggest that cannabinoids for epilepsy are ready for prime time.

Esther @42:
Orac asked for adults with autism to post about their experiences with dope; Panacea did so; he has exactly as much credibility as you.
Or me, for that matter, as an adult with Aspergers. I gave up on dope because it gave me paranoia and panic attacks, perhaps because I was misreading signals and picking up on random background visuals and sounds even more than usual.

Panacea says (#24),

Basically the parents want to dope up their kids to eliminate behaviors in autistic children that are difficult to deal with.

MJD says,

It may be that parents of autistic children want to safely and effectively use cannabis oil to increase their child's signs of well-being including laughter, affected appetite, and sociability.

What's wrong with that if such behaviors are triggered by said oil? Medically prescribed and monitored of course (e.g., THC expression in blood).

It may be that parents of autistic children want to safely and effectively use cannabis oil to increase their child’s signs of well-being including laughter, affected appetite, and sociability.

What’s wrong with that if such behaviors are triggered by said oil? Medically prescribed and monitored of course (e.g., THC expression in blood).

People like you make ludicrous claims that there are no safety studies of vaccines and they are the devil's spunk. But, safety and efficacy studies go completely out the window when it comes to trying to "fix" or "recover" your autistic children.

@ Freedom Fighter (#34)

I've long since thought that "big pharma" and "big tobacco" have more interest in seeing cannabis legalized than not. There are quite a lot of potential lead compounds for drug development in cannabis, so pharmaceutical companies could stand to make a profit there.

I've never met a person who interchanges marijuana usage with tobacco usage, and due to the popularity of smoking marijuana with tobacco in many places it seems to me "big tobacco" also stands to gain from legalizing cannabis.

As for "big alcohol," I don't see why they would stand to lose from legalization either. Would people just drop the bottle and pick up a joint if marijuana were legalized? Considering how dissimilar the two drugs are, I tend to doubt it.

the word 'marijuana' is considered a derogatory term used by those who still want it to be illegal. What some of us are trying to do is to always refer to it as 'cannabis'. Medical cannabis. Please join us :)

No thanks, I'll decline. I see no problem calling it by its name nor do I see any reason to change.

#32 notadoctor, racist?

the word ‘marijuana’ is considered a derogatory term used by those who still want it to be illegal.

According to whom?

I suppose they really don't like it when I occasionally use the term "weed" to describe marijuana. :-)

Anyone who refers to cannabis as 'dope' has no credibility.

Those who wish to boost their credibility by claiming to have used cannabis, good luck.

@Den!s - I'll consider using the term "medical cannabis" when someone is able to show:
- What's the difference between medical and non-medical cannabis; and
- That there is strong evidence that cannabis is a safe and effective treatment for some medical condition.

Precisely.

Meph O'B, How strong is the evidence that Sativex is a safe and effective treatment for MS?

Why call it 'cannabis' or 'medical' cannabis? Why not use the product name to describe it? Bedrocan? Cesamet? Nabilone? Marinol? Bedica? Bedrabinol? These are all standardised medications.

"Orac asked for adults with autism to post about their experiences with dope"

For my anecdote please see other anecdote.

What seems to be a defining feature of a lot of marijuana users is the ability to spontaneously delete information in their brain that isn’t in accordance with their ideas.

I'm late to the party, but I'd say this is a defining feature of humanity in general - including skeptics. Skeptics just try to be more aware of and to actively combat the tendency.

How strong is the evidence that Sativex is a safe and effective treatment for MS?

Apparently strong enough for it to be approved in 15 countries. However, that wasn't what I understood was meant by "medical cannabis".

There's a kind of invisible prejudice. It's like racism, but towards cannabis users, and maybe towards 'druggies' in general.
Their language is so fraught with it, do they even realise they're doing it?
Will they look back on this in 50 year's time and realise it looks bad, a bit like suggesting that Jamaican studies can't be credible looks today?

Sativex is cannabis.
Plus ethanol, peppermint, and ethylene glycol.

In other anti-vax/ autism news:

although Dan hasn't posted anything on Saturdays as he was wont to until recently, something interesting has occurred on John Stone's post about DeStefano:

an MPH, PhD, Joel Harrison, has been allowed to post highly critical comments that explain research and critique woo-ful objections SEVERAL TIMES.
IIRC, he may have been around here.

Sativex is cannabis.

Is this more true than saying that digoxin is foxglove or that taxol is a yew plant?

If you don't like Sativex then use Bedrocan which is cannabis flower heads. Every plant is a clone grown under standardised conditions. You can find out which conditions it is approved for in Holland here http://www.ncsm.nl/

Sorry the English version of the website doesn't have the information you need so I've asked a Dutch friend to translate it for us. Please be patient...

Sativex is a mixture of a full spectrum CO2 extraction of the oils from the flower heads of two different cannabis sativa cultivars.
Like Bedrocan, every plant is a clone grown under standardised conditions.

So no, nothing like a single chemical extracted from a plant.

Lovely! So in Holland your GP can prescribe you 'medical cannabis' (Bedrocan) and your insurer will pay for it and buy you a medical grade vaporiser *grin emoticon*

The list of conditions:

- Ailments with spasticity in combination with pain (Such as MS, bone marrow damage)
- Chronic pain (More specifically, that of neurological origin)
- Nausea and vomiting caused by chemo therapy or radiation in order to treat cancer, HIV combination therapy or accompanying medication for the treatment of Hepatitis C
- Palliative treatment for cancer and AIDS: For improving the appetite, and decreasing pain, nausea and weight loss
- Gilles de la Tourette Syndrome
- Therapy resistant glaucoma

Science Mom says (#40),

People like you make ludicrous claims that there are no safety studies of vaccines and they are the devil’s spunk.

MJD says,

In contradiction, both of my autistic children were fully vaccinated and as adults-with-autism I support their use of vaccines and cannabis oil when applicable.

@Orac,

When are you going to have a Respectful-Insolence conference?

I'd suggest having it on a whaling ship wherein the Oracian pod (i.e., Orac's minions a.k.a. The Borg) can laugh together, in respectful insolence, and chew on strips of whale blubber fried in a 55-gallon steel drum of cannabis oil.

@ Esther Knight
I'm not going to translate the whole piece. The website is by an organisation to promote medical cannabis, so hardly a neutral organisation. Besides the organistation doesn't exist anymore.
Not all insurers are paying for it, and mostly in very specific circumstances.

http://www.ncbi.nlm.nih.gov/pubmed/23867051

It wasn't the cannabis that caused their psychosis. It was your systematic bullying!

Renate my Dutch native here says you're being economical with the truth, and misleading this mostly monolingual English-speaking audience.

Nou, dat lijkt me een beetje vergezocht.
Je herhaalt dus letterlijk wat de website aangeeft alsof het wat bewijst. Verzekeraars hebben ALTIJD voorwaarden.
Als je Nederlandstalige bron net zo sterk is als je denkt, kan het ook geen enkel probleem zijn dat ik deze reactie in mijn moedertaal aanbiedt.
De organisatie aangehaald werkt nauw samen met de overheid, en de overheid heeft haar eigen departement om toezicht te houden op medicinale cannabis. Men is zeer nuchter over wat het wel en niet doet, en het is zeker geen propaganda, daar het de mythe dat "cannabis kanker geneest" meteen de grond inboort met studies.

Maar goede bluf, desalniettemin.

the word ‘marijuana’ is considered a derogatory term used by those who still want it to be
illegal.

Yes, Den!s #42.. but *racist*, #44? It is no less racist nor more stereotypical than poor translations of ebonics or jive.

Prior to 1910, “marijuana” didn’t exist as a word in American culture. Rather, “cannabis” was used, most often in reference to medicines and remedies for common household ailments. In the early 1900s, what have now become pharmaceutical giants—Bristol-Meyer’s Squib and Eli Lilly—used to include cannabis and cannabis extracts in their medicines.

https://www.leafly.com/news/cannabis-101/where-did-the-word-marijuana-c…

I see no problem calling it by its name nor do I see any reason to change.

What's in a name, Orac? For your profession was derped back then as they were late to the prohibition party having not yet associated the name of the evil weed, marihuana, with their medical use of 'cannabis' -- Your soul AMA emmisary sent to oppose the agregeous farce, the kickoff of eighty years of draconian cruelty, berated and hung out to dry as a warning to other 'doctors'.

What is in a word, Orac?

=============
Dr. Woodward: I use the word "Cannabis" in preference to the word "marihuana", because Cannabis is the correct term for describing the plant and its products. The term "marihuana" is a mongrel word that has crept into this country over the Mexican border and has no general meaning, except as it relates to the use of Cannabis preparations for smoking. It is not recognized in medicine, and I might say that it is hardly recognized even in the Treasury Department.

Dr. Woodward: We cannot understand yet, Mr. Chairman, why this bill should have been prepared in secret for two years without any intimation, even, to the profession, that it was being prepared.

The Chairman: If you want to advise us on legislation, you ought to come here with some constructive proposals, rather than criticism, rather than trying to throw obstacles in the way of something that the Federal Government is trying to do.

The Chairman: The fatal marihuana cigarette must be recognized as a deadly drug, and American children must be protected against it.

http://www.druglibrary.org/schaffer/hemp/taxact/woodward.htm

Wow. ^^ There really are a lovely bunch of cocconuts, in that one!

It is rather silly that you seem to be attributing the attitude of a doctor from nearly 80 years ago towards marijuana to me given that I said more than once in this post that I support legalization.

Gilbert. My comment #44 was referring to the

"pfft jamaica."

Racist comment at #32 by notadoctor

It wasn’t the cannabis that caused their psychosis. It was your systematic bullying!

"High" (or, depending, "stoned") and "coherent" are not mutually exclusive categories, BTW. You might want to try out the combination.

Gilbert. My comment #44 was referring to the

“pfft jamaica.”

Racist comment at #32 by notadoctor

Impressively, you can't even identify sarcasm or, more precisely, someone who is vaguely agreeing with you. I guess actually reading the link was too much effort.

Narad maybe you are right @#70 ?
My autism might render me vaguely blind to vague agreement.

What is that word-salad at @#69?

Was reading the article in notadoctor's post #32 and found this:

But it's alleviated some of his severest symptoms so that he, my husband, and I can actually enjoy each other, rather than being held hostage by his autism in a house full of screams, destruction, and three very unhappy people. [emphasis mine]

mlMore or less the attitude I expected. I'd hazard that it's more about her and her husband enjoying the silence than any consideration for the child.

Also, what was the point of notadoctor's link farm?

"...given that I said more than once in this post that I support legalization.

Orac, you could start referring to yourself as 420 friendly. That's a term they should understand.

Of course, that term applies to equally to supporters and users so I can see where identifying as such would be problematic for you.

Je herhaalt dus letterlijk wat de website aangeeft alsof het wat bewijst.

The evidence base for CINV is pretty thin, as well, but this has nothing to do with the topic at hand.

Esther Knight, #47
"Anyone who refers to cannabis as ‘dope’ has no credibility."
How dare you? I could bet the reference is right, on such authorities as Gilbert Sheldon's Fabulous Furry Freak Brothers!!!
https://en.wikipedia.org/wiki/The_Fabulous_Furry_Freak_Brothers

Narad,

Not understanding sarcasm goes with the territory.

https://www.nlm.nih.gov/medlineplus/ency/article/001549.htm

Yes, Ester; It was 'sarcasm'. from *Conclusions* of the Jamaican study:

Clearly, these results suggest that we examine the caretaking environment that has the capacity to
overcome the potentially adverse effects of marihuana.

The community based field studies and home interviews reveal that the sharing and smoking of ganja... In Jamaica as an overture and confirmation of frienship and mutual assistance... The lifestyle of ganja users suggests a lively houlsehold with many child caregivers, more infant stimulation and playfulness.... the differences in infant scores at 30 days is most likely attributable to the differences in the richness of the environment...

Well, I'd still not recommend Showtimes' Shameless as the definative replacement for 'Dr. Benjamin Spock' for raising children; But I am fireing up to the idea.

How dare you? I could bet the reference is right, on such authorities as Gilbert Sheldon’s Fabulous Furry Freak Brothers!!!

I've actually had reason to invoke this in all seriousness not too long ago. (I'm not sure I totally agree; the anxiolytic effect is certainly welcome, but the general distractability isn't so helpful overall.)

I'm mildly surprised that I'm not turning up an image of "no gas, no grass, no ass, no ride." In any event, I use whatever euphemism I feel like,* depending on context.

"The free, playful entertaining flight of ideas is bullshіt; and more often than not will be found afterwards to accord perfectly with universal truth."

I am wholly indifferent to random, blanket babbling about "credibility" based on vocabulary.

* Some quite obscure. I happened to be on a mission to the Puget Sound this week, which has its very own. One curiosity was that one of my hosts showed me his collection of (now legal) grass; it was all in the 20%-and-up THC range, except for the one that was open, which was <2% THC and around 18% CBD.

The effects were... interesting (don't let anyone tell you that CBD isn't centrally active), but I wound up trying to figure out a way to sidle up to the question "Um, D—, how did you happen to pick this?" D. is no novice but was completely unaware of the distinction. I'm quite curious what's going to happen when the next variety comes out of the cigar box.

What is that word-salad at @#69?

Maybe your Dutch native there can explain it to you.

I happened to be on a mission to the Puget Sound this week, which has its very own. One curiosity was that one of my hosts showed me his collection of (now legal) grass; it was all in the 20%-and-up THC range,

I always knew the weed back in Olympia was crazy strong. I'm totally jealous, btw. Well - I'll be making a trip back that way this winter, I'm sure.

One… (something, something)… over the line…

There is a wonderful and hilarious video of this “modern spiritual” being performed on The Lawrence freaking Welk Show, just by the by.

Lawrence Welk reruns on Saturday evening from a distant public TV station were a great way to ease coming down from the Supreme Sacrament back in the day.

A long time ago, in Guitar I or II at the Old Town School, I put in "One Toke" as a class selection, which was promptly embraced by the instructor. But anyway, I think that Tarkio is underappreciated as an album. It's nothing like Melanie's Gather Me, which is criminally given short shrift, but it holds together OK.

I always knew the weed back in Olympia was crazy strong.

The word I got was that the supply chain originated in British Columbia in the pre-prohibition days. I'm not sure how it's regulated now. (The only security in the priority line SEA–ORD last Wednesday, for whatever reason, was being sniffed by a dog.)

I'm over 21 and live in Washington state, which means I can legally and without a prescription buy any of the following (among many other things): vodka, acetominophen, aspirin, vitamin D, marijuana buds, THC extracts, tobacco, coffee, and Sudafed.

Knowing that doesn't tell me which, if any, of them might be helpful for a given symptom or chronic condition. Sometimes the answer is "none of those, but chicken soup won't hurt" or "rest, ice, compression, elevation."

What a number of people don't seem to realize is that "if cannabis won't solve this, what's better?" isn't actually evidence in favor of cannabis. The argument is equally valid, or rather equally invalid, if someone says "but if tobacco won't cure my cousin's cancer, what will?" or "how dare you say rum won't cure the common cold? Have you got something better?"

Yes, legalize it; but if I did get cancer, I'd like to be able to ask my doctor whether THC is likely to help, harm, or neither and get an evidence-based answer.

Gilbert how was I to know?
There actually ARE people on this blog who really DO think Jamaican studies are somehow inferior to white american studies.

Your parody of racist words was a parody, and the words were racist. Is it funny? Should it be seen as a joke or a problem here?

Funny, when I hear the topic of debating the merits of the legalization of pot, all I can think of is this classic from the 70's:
https://www.youtube.com/watch?v=ZhedkY_TmXI

There actually ARE people on this blog who really DO think Jamaican studies are somehow inferior to white american studies.

You arrive at this freakishly specific conclusion how?

As an aspie who spent a significant amount of my 20s enjoying or at least trying to enjoy cannabis in its various forms, I have to say that (1) it turned just about anything into a near-orgasmically sensual experience, at least if I was left to experience it in my own head, but (2) as for social anxiety, a distinct symptom of my aspie-ness, it only made it worse. Far worse. I gave it up because, frankly, people scared me while I was on it. Stoner paranoia is a thing, and it led to some seriously bad experiences.

Everyone on the autism spectrum is an individual. It might well be true that cannabis could be helpful in some cases. But I can easily imagine it being a horrible experience in others. Giving it to a child without knowing what the reaction will be seems borderline abusive to me.

Narad, this blog is racist. Don't cry.
Actions speak louder than words.

If there is a single person amongst you who wants ME to be criminalised for using cannabis to reduce MY autism symptoms, come out and say it and explain yourself.

"This blog is racist"? WTF are you talking about?

As for the "criminalization" part, no one has said that, so, really, WTF are you talking about? Note that there is a huge difference between adults and children. I generally support the right of an adult to use pretty much any treatment he or she desires (or to refuse any treatment he or she desires), but children are a different matter, and a much higher standard is called for. Children are autonomous beings who have the right to be protected from potentially harmful decisions by their parents with respect to their medical care.

There actually ARE people on this blog who really DO think Jamaican studies are somehow inferior to white american studies.

Oh, really? Who? And on what basis do you draw this conclusion? It's easy to cry "Racism!" Proving it, not always so easy.

No Orac not you, you just tolerate it.

Your title: Evidence prevails
Should read: Lack of evidence doesn't prevail.

To you and me, details matter.

To you and me, details matter.

They matter to other people too. That's why they're asking for any evidence for your "here actually ARE people on this blog who really DO think Jamaican studies are somehow inferior to white american studies.".

I would hazard an opinion that to the regulars here it is irrelevant where the study originated, because what is evaluated in a study is the content.

As for my opinion on the topic - legalize and regulate like alcohol, with growing for personal use allowed, ease up regulations for study but require adequate studies before prescribing it medically. Adult anecdotes for cannabis, like for any other potential drug, do not adequate studies make.

"Evidence" prevails is correct because the totality of the existing evidence does not even come close to supporting the use of cannabis oil for autism, period.

How on earth can you find it remotely acceptable to continue to risk giving Risperidone to autistic children or adults in MI when you know perfectly well that cannabis is much less risky and may be more effective?

In my humble opinion, may be more effective is inadequate for medicating children. With anything (with the possible exceptions of chicken soup and ice cream).

And yes, I am concerned about over-prescription of psychotropic (and other) drugs, and would prefer alternatives but adding another psychotropic drug to the list without showing efficacy isn't the answer - and replacing a drug that has evidence of efficacy with one without is irresponsible. In my honest opinion.

That for children. For adults, they're free to make their own choices about what medication or medical interventions they take or not. But that said, for Cannabis to be paid by the local national health care service, for example, I'd except evidence of efficacy too. But even if not compensated, I'd legalize it and leave it to adults to indulge responsibly and/or self-medicate with it if they so chose.

How on earth can you find it remotely acceptable to continue to risk giving Risperidone to autistic children or adults in MI when you know perfectly well that cannabis is much less risky and may be more effective?

Because I "know" nothing of the sort. There is zero reliable evidence that cannabis is more effective than Risperidone. Zero. Not even the anecdotal evidence is that convincing.

Esther, I don't want to criminalize you using cannabis to treat your autism symptoms. I'm fine with any adult using cannabis just for the hell of it, or if (they think) it helps their medical issues; that doesn't mean I think it's a good idea to give it to autistic eight-year-olds who may not be able to express that they feel worse after being given it. (I assume you agree with me that autistic children shouldn't be kept drugged with opiates in order to give their parents peace and quiet.)

If you want to organize a separate campaign to stop giving Risperidone to autistic children, in Michigan or anywhere else, show the evidence that it's harmful and we might even back you up. But that is a separate issue from whether to give cannabis to children.

If there are two or more actually helpful treatments, a patient (or their parent/guardian) and their doctor can reasonably consider "this one has fewer nasty side effects" or "let's see which one I can tolerate better." If there's only one useful treatment for a problem, the comparison becomes "is this better than no treatment?" That a drug or herb is useful for one condition doesn't mean it will help another; I don't expect ibuprofen to help a cough or stomach ache, or take an antibiotic for a viral infection.

Orac says (#90),

Children are autonomous beings who have the right to be protected from potentially harmful decisions by their parents with respect to their medical care.

MJD says,

Great, so let's have free and easy medical care for every child in this country so a distressed and uninformed parent doesn't have to rob a bank to manage their child's eye cancer.

Great, so let’s have free and easy medical care for every child in this country so a distressed and uninformed parent doesn’t have to rob a bank to manage their child’s eye cancer.

While I don't see how the one statement follows from the other, there are certainly people who support paying for all health care via tax dollars and countries that have done so. Work on convincing the taxpayers that it's a good idea, and they'll convince Congress to act.

There was a study on ADHD and crime.
Found double the crime rate. Half of the crime was for possession of illegal versions of ADHD meds,. Go figure.

I'm old enough to remember when hyperactive kids with poor impulse control were just regarded as behavior problems, and treatment was limited to being ostracized by their peers and beaten by their parents.

A lot of them ended up as addicts and petty criminals. Briefly. Before dying young. Long before the prescription of stimulants became commonplace. Go figure.

Meds don't work for everybody. And nothing works all that well for any child, with or without ADHD, who doesn't have support at home. But for a kid who otherwise could not sit still long enough to learn to read or make a friend, meds are a help and a benefit.

It's really kind of vile of you to be banging that gong to advance your own interests without sparing a thought for that. Do you want people who find it beneficial to take meds to suffer for your prejudices?

Before I do, just do yourself one favour.

Google 'cannabis tourettes youtube' and you may see some Europeans with severe 'problems' and those problems appear to disappear almost immediately upon vaping Bedrocan.

If you can look at those videos and see only charlatanry, please explain?

@#102 --

"Charlatanry" and "miracle drug" are not the only potential explanations. You realize that, right?

I watched a video of a very tic-y guy in Germany. If that's the one you mean, it's impossible to say what's going on there. A lot of people with Tourette Syndrome can voluntarily suppress their tics without any medication at all. But it makes them tense. So it's possible that he's alleviating the tension, not the tics per se.

That might be incredibly helpful for some people. And it wouldn't be charlatanry. But it also wouldn't be a miracle cure.

But, you know. Anything's possible. It's a four-minute video on the internet.

Yes Ann you are right, and if motivated enough you can actually make friends with people with Tourettes who find cannabis useful. Then things will either become more or less clear.

My final offer to Orac: Sir, can I help you find some cannabis-using autistic adult friends in Detroit if you wish?

you can actually make friends with people with Tourettes who find cannabis useful.

I am a regular cannabis user who also has Tourette. I live where marijuana is broadly legal. You know what? Cannabis most certainly makes my Tourettic symptoms worse. As much as I love cannabis, I can only consume while also taking meds to manage my tics.

Esther, if motivated enough you can actually make friends with people with Tourettes who don't find cannabis useful too...

AdamG most medicines don't even work for half of all people with the same diagnosis!
We know people like you exist too, and we are sorry to forget to include you. Thank you. I've known two people with Tourettes and never noticed cannabis effecting them one way or the other.

AdamG most medicines don’t even work for half of all people with the same diagnosis!

What percent of children with autism is cannabis effective for? We don't know. That's why it should not be approved for this use given the current knowledge base.

@#104, #106 --

OK. Now I'm confused.

I've known two people with Tourette's well enough to have some sense of what the disorder was like for them. It was co-occurring with an assortment of other stuff for both.

One of them was able to live with it, in part because of psychotropic meds. But I believe he took those mostly for the OCD. So he had no use for cannabis.

One of them had schizophrenia. He also took psychotropics, but neither the voices nor the tics were completely controlled. And whatever else cannabis may or may not do, I'm pretty sure it's kind of a risk for people with psychotic disorders.

^^That's anecdotal. So is the evidence that cannabis works for Tourette's.

So reality is basically:

Smoking pot makes some people feel good.

If that's the case, and smoking it doesn't interfere with other aspects of their lives and functioning, more power to them. But that doesn't mean that pot has medical value. You could say the same thing about alcohol.

And it's not always the case. Some people smoke pot because it makes them feel good until it leads to years of social isolation and not being able to get anything done. You could, again, say the same thing about alcohol.

There's a big difference between that and -- for example -- stimulants as a treatment for ADHD. Like so:

On the one hand:

Stimulants reduce the symptoms of ADHD eighty percent of the time. Not forever, not completely, and not without side effects. All three of those things is a significant drawback. But as far as it goes, it's proven to be an efficacious treatment.

On the other:

Some people like smoking pot. They find it helpful in a wide variety of non-specific ways. Others don't.
_____________

Is there some reason why that's not satisfactory to you?

most medicines don’t even work for half of all people with the same diagnosis!

Citation needed.

...

If you mean neuropsychiatric disorders, it's true that for some, meds either don't always work or don't always work well or only work at a very high cost, side-effect wise.

That still doesn't mean that cannabis is a treatment. It just means that there are not very effective treatments for some neuropsychiatric disorders and that smoking pot still makes some people feel good.

You could say the same thing about alcohol.

ann #108; Sometimes, you certainly can:

Benign essential tremor is treated with alcohol in moderation. Beta-blockers or primidone are also used.

http://patient.info/doctor/abnormal-involuntary-movements

Hmm. I wonder if some cases develop as a response to the brain being Ritalin-'leaned-out'; I wonder if there would be fewer of these types of palsey if the hyper brain had been cannabinoid 'chilled out' instead?
==========

I did not indend to seem "rather silly", Orac #67. You saw no problem calling calling cannabis 'marijuana'; I only sought to edify by demonstrating the M-word was deliberate conflation that also hoodwinked doctors. This history of the word was not known to yourself, I trust? A forgivable oversight because, as you say, the blog is not 'racist'.

The article I linked notes:

others insist that the term has now lost its prejudiced bite

However, The M-word was promoted throughout america and on the 'Big Screen' (Reefer Madness) by a flamming racist; Presumably to play to other racists throughout the populace but especially to those in positions of power (the kids were never fooled.. Marijuana -- The Assassin of Youth, LoL).

Most marijuana smokers are Negroes, Hispanics, jazz musicians, and entertainers. Their satanic music is driven by marijuana, and marijuana smoking by white women makes them want to seek sexual relations with Negroes, entertainers, and others. It is a drug that causes insanity, criminality, and death — the most violence-causing drug in the history of mankind.

and

“Reefer makes darkies think they’re as good as white men…the primary reason to outlaw marijuana is its effect on the degenerate races.”

-- Harry J. Anslinger, The first director of the Federal Bureau of Narcotics.

Mrs. Grimble #38: actually MJD asked the question, but yes my response was in answer to it.

MJD: in response to when you said, "It may be that parents of autistic children want to safely and effectively use cannabis oil to increase their child’s signs of well-being including laughter, affected appetite, and sociability.

What’s wrong with that if such behaviors are triggered by said oil? Medically prescribed and monitored of course (e.g., THC expression in blood)."

Please prove to me that cannaibis oil does any of those things. Please prove to me it does so safely, without causing addiction or problems with higher brain function that we KNOW is a side effect of chronic marijuana use in younger people (before the age of 21).

Esther: I find your comments on marijuana treating your symptoms of autism to be hysterically funny, and I call BS on it. Other than stimming, which can sometimes result in self injurious behavior, the "symptoms" of high functioning autism are primarily perception in communication. So what you're really telling me is pot alters your perceptions and somehow improves your communication skills? Or maybe it just alters the perceptions of others in some way? Makes you easier to deal with?

In any case, I don't think I have any symptoms of Asperger's that require any form of treatment. This is simply who I am. There's nothing wrong with me. All I've ever had to do is focus a bit more when communicating with others to try and understand how they might be perceiving me, to avoid social conflict. Every other Aspie I know is the same way, not a single one I've ever known would ever say they needed medication to treat anything.

Either you're a parent of an Aspie who's having trouble coping, or you just want to get high.

And even if I'm wrong on that (not impossible), see my answer to MJD: where is the evidence that cannibis oil does anything beneficial for kids or adults with autism at any point on the spectrum? Describe that benefit.

I wonder if some cases develop as a response to the brain being Ritalin-‘leaned-out'; I wonder if there would be fewer of these types of palsey if the hyper brain had been cannabinoid ‘chilled out’ instead?

And I wonder if heaven got a ghetto. And also who wrote the book of love. Plus when you stopped beating your wife.

If you want what you said to make more sense than that, you could start by explaining exactly what "a hyper brain" is and what "a chilled out" brain is.

Because you seem to be confusing vaguely conceived and not necessarily pathological mood states with neurology.

@Adam G #107 a conservative lower bound would be to guess that cannabis works with less than 1 in 40 with autism.

That way we will always be fucked. Thanks.

The lady who wanted a citation for meds working with less than half, I'm changing that to a third and you can still go get your own citation for that, it's closer to a quarter actually.

Sorry for f*
It's bank holiday me and dinny are drunk

That's fascinating. How everybody must envy you.

Panecea says (#111),

...where is the evidence that cannibis oil does anything beneficial for kids or adults with autism at any point on the spectrum? Describe that benefit.

MJD says,

Briefly, it is well documented that humoral immunity (e.g., hyper-adaptive immunity) has been shown to affect the incidence and atypicality of autism spectrum disorders.

Medical research indicates that cannabis oil has an immunosuppressive effect on humoral immunity.

http://www.marijuanalibrary.org/JOPD_Immunity_Hollister_92.html

Therefore, cannabis oil may be a useful treatment that inhibits the progression of regressive autism based on its immunosuppressive characteristics.

Esther: no guessing, please. This is science. We operate on facts, not guesses.

You're the one making the claims. Sober up and do your own research. It's not up to us to prove that marijuana does NOT work. It's up to you to prove that it does.

Good luck with that.

No, if marijuana (in any form) doesn't work for people with autism, researchers will keep looking until we find things that do. Marijuana won't cure strep infections, either: that doesn't mean nothing will.

Heck, even if it is proven to help, people will look for alternatives, because some people get unpleasant side effects from cannabis, some actively dislike being stoned, and some would like a treatment that they can use and still drive a car.

@Esther Knight --

I realize that you and Dinny are having a very important drunk and everything.

But WTF are you talking about? Antidepressants work for about a third of the people who take them. However (a) anti-depressants =/= meds; and (b) a lot of that is because antidepressants are over-prescribed to people who don't need them.

They' also don't work for everybody who needs them. But neither does anything else. That's not because antidepressants are evil. It's because depression is difficult to treat.

May I just say again that while it's great that smoking pot makes you feel good, it's really kind of vile of you to be parading around demanding that the whole world bow down to your preferences? Because it is.

I mean, if the pot is really working, how come you still need to go to such lengths to make yourself feel big by looking down on others anyway?

@Adam G #107 a conservative lower bound would be to guess that cannabis works with less than 1 in 40 with autism.

I'm certain that your showing your work will be fascinating.

*A very hungover essie will get you citation later.
not 1 in 40 that's a mistake. It's 1 in 1200.

Here is the article: http://www.medscape.com/viewarticle/453220

Making pot does not make me feel good. I feel great without it and feel just a little bit worse with it. The reduction in autism symptoms is worth having so I put up with the mild side-effects.

No pot: feels 11/10
On pot: feels 9.5/10 and never get crap off anyone for having an orgasm face at a funeral.

@Esther Knight --

OK. In that case, I think it's great that smoking pot works for you in some circumstances without making you feel more than a little worse, in much the same way that it does for every other pot aficionado -- ie, as a social aid.

And the rest of what I said still stands. That doesn't mean it's a medication, or that it has medicinal value.

I don't blame you for disliking meds either, btw. If they don't help you, they don't.

It's the generalizing of your experience to a universal truth that I have a problem with.

Therefore, cannabis oil may be a useful treatment that inhibits the progression of regressive autism based on its immunosuppressive characteristics

MJD, the evidence demonstrating that immunosuppression inhibits the progression of regressive autism would be what, exactly?

MJD @ 116
I find it's best to ignore someone like Panacea,who clearly would not know regressive autism,if it crawled out of the sewer and bit them on the rear end.

I read your link about marijuana and immunity,and the first thought that came to mind was that for regressive autism,cannabis,is,at best,a band-aid solution.One that would only possibly treat symptoms,but not get to underlying causes.Not to mention cannabis is a treatment with many heath risks that would not justify the questionable,benefits for a child with immune and metabolic impairments.

Individuals with severe or regressive autism often are found to have inborn disorders of folate metabolism,and disorders of redox metabolism and mitochondrial dysfunction.These can be inherited through family history,or the results from exposures,and deficiencies,while the child is in the womb.The latter is usually what is meant by "environmental exposures" in autism,not vaccines.

Folate
http://www.jimmunol.org/content/173/5/3186.full

Redox/CoQ10
https://www.grc.com/sr6dev/misc/coq10/Q10%20-%20Gene%20and%20Metabolic%…

Correcting these deficiencies often normalizes mitogenesis,and immune function.It is much safer than marijuana.I need only to look at my history of one regression after another,triggered by acute infection,or undiagnosed metabolic crisis,from the time I was an infant,until well into my 40s.These regressions were stopped,and well as my immune issues,like frequent pneumonia and lower respiratory infection,were reversed by treating these metabolic problems.

As a social aid? We are not talking about passing a joint round hippy friends.
We are talking about passing for someone who always has red eyes in the office instead of a total freak.
I smoke in the morning, I smoke before I go to work, I smoke at lunch, I smoke after work, I smoke in the evening.

If you stop taking your meds regularly they say you are 'not compliant' and you get all sorts of recreational effects creeping in.

To be clear, we are not 'cancelling out your idea of autism symptoms with your idea of recreational pot effects'. No.
We are reducing core symptoms of autism. While we quickly develop a tolerance to the recreational effects (side effects) we continue to get the same reduction in autism symptoms.

Individuals with severe or regressive autism often are found to have inborn disorders of folate metabolism,

Interesting, Roger Kulp #127. Your link seems to indicate the use of *pteroylglutamic acid*; The synthetic *folic acid*?
As

However, folic acid is a synthetic oxidized form, not significantly found in fresh natural foods. To be used it must be converted to tetrahydrofolate (tetrahydrofolic acid) by dihydrofolate reductase (DHFR).

and

Their biological availability to the body depends upon dihydrofolate reductase action in the liver. This action is unusually slow in humans, being less than 2% of that in rats. Moreover, in contrast to rats, an almost-5-fold variation in the activity of this enzyme exists between humans. Due to this low activity, it has been suggested this limits the conversion of folic acid into its biologically active forms "when folic acid is consumed at levels higher than the Tolerable Upper Intake Level (1 mg/d for adults)."

and

Folic acid therefore enters via a different carrier system from naturally occurring folate, and this may have different effects on folate binding proteins and its transporters. Folic acid has a higher bioavailability than natural folates and are rapidly absorbed across the intestine

It *may* seem plausible that increasing unmetabolized synthetic *folic acid* stores (generally, believed to be not so
good) further downregulates the production and processing of the bioactive form, 5-methyltetrahydrofolate

in the absorptive cells of the small intestine from polyglutamylated dietary folate.

https://en.wikipedia.org/wiki/Folic_acid

With what is known now, would it not be prudent, following the precautionary principle, to recommend that autistics and others with known folic acid metabolism deficiencies (such as the elderly) be advised to avoid it?

^^In practice, The distinction cannot be determined from food labels directly such that this is an arduous request given the ubiquitous nature of the petroleum-derived *folic acid* and its conflation and confusion with *folate* in this age of mandated fortification.

Back in my late teens in the early Seventies, I smoked a fair amount of what we called "dope" back then, no apologies for using the word.
It did not improve my social functioning, stimming, klutziness, or focused interests. On the other hand, my friends were all so stoned that no one noticed any of it.

I smoke in the morning, I smoke before I go to work, I smoke at lunch, I smoke after work, I smoke in the evening.

It shows.

RE: MJD's idea that immuniosuppresion may be useful in slowing the progress of regression, why in the world would anyone suggest using marijuana as the immunosuppressant when there are well characterized, FDA approved immunsuppresants like rapamycin and cyclosporin available for use?

@34 Freedom Fighter. Then please post the link to the CDC page to back your claims up. Like this http://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm

@50 Esther Knight. Sativex is an oral spray that can help with some of the symptoms of MS. A meta-analysis showed there was a trend towards a reduction of spasticity in the illness, but it wasn't significant, statistically that is https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2793241

Also, and I quote: ''Due to low bioavailability of oral THC formulations, alternative routes of drug administration, including oromucosal or sublingual dosing, vaporization of product and inhalation, and rectal administration, have been developed to improve the amount of delivered cannabinoids.'' http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2689518/

@130

ORD,

There you have it! Cannabis use in others greatly reduces awareness of autism symptoms! Now if only someone could design a study...

Narad, that's your little imagination showing you things.

How can you see my orgasm face? Are you hacking my webcam?

Guys, we use it in secret to pass as non-autistic amongst sober people where we work. There is no hippy party, just forget about your hippy party / friends too stoned to notice hypothesis.
If you want out anecdotes please don't derail the thread with your fantasies and throwback memories.

Narad, that’s your little imagination showing you things.

How can you see my orgasm face?

How can you? Mirrors don't seem to be your gig.

Narad, face to face interaction matters to girls.
Someone please explain him, I have to go to work.

Actually, Esther, I'm not interested in your anecdotes. Should you ever have something resembling evidence in support your claims to offer, on the other hand, I'd certainly be interested in considering it.

We are reducing core symptoms of autism.

What you're describing doing is altering your subjective perceptions of yourself and/or what other people think about you. Or that's what it sounds like, anyway.

We are talking about passing for someone who always has red eyes in the office instead of a total freak.

People who regard others as total freaks are...Well. I don't know what they are. F*cked up people.

To regard oneself as a total freak (or to fear being seen as one) is obviously a very painful thing. So I don't want to presume you feel that way. But fwiw, I'm sure you have no reason to. Because there is none.

I think that might be one of those things that suddenly becomes self-evident after you've already wasted a decade or two being pointlessly miserable about it (aka "the wisdom of age.")

But oh, well. Say ooh la la.

You need to change the name of this blog as you have no idea what science is. There is plenty of research to support the use in autism. You chose to believe a bureaucrat instead of the medical review board that approved the use in Autism by a vote of 4 to 2.

There is plenty of research to support the use in autism.

And your citation list would be...?

Give Orac a break. He's never known autistic people who use cannabis so he's correct to say that he, himself, has no evidence.

Ann, I had to phone a friend.
Autism is a behavioural diagnosis, so referring to the legal version of successfully medicating as 'reducing symptoms' while referring to the illegal version as 'masking symptoms'? Possibly makes sense with your emotional bias but not in my real world.

Perhaps your unicorn would like to teach my co-office workers all about autism?

I didn't say "masking symptoms." I also didn't suggest that cannabis had that effect.

I said that what you were describing sounded like an alteration of your subjective perception of yourself and/or how other people think about you.

Or if that's too hard to follow: It sounds like you're describing a change in how you feel about yourself and/or how you think other people feel about you.

And just in case it isn't clear:

I'm not saying that's what's happening. I'm obviously not in a position to know, one way or the other. How could I? I'm just saying that's what you seem to be describing. I base that on your descriptions.

Meaning these ones, right here:

On pot: feels 9.5/10 and never get crap off anyone for having an orgasm face at a funeral.

We are talking about passing for someone who always has red eyes in the office instead of a total freak.

How can you see my orgasm face? Are you hacking my webcam?

Guys, we use it in secret to pass as non-autistic amongst sober people where we work.

So. I do see mention of one symptom.

But what you're literally describing is a perceived change in other people's behavior, not yours. If that's not what you intend to convey, describe the symptom reduction.

Perhaps your unicorn would like to teach my co-office workers all about autism?

^^I missed that one.

I mean, I assume that your co-workers are not keeping careful records of your facial expressions under pot and non-pot conditions,

But beyond that, I'm not sure exactly what you're saying. How are you gauging their response to you?

Ann, I have to concentrate continuously to avoid adopting an open-mouthed appearance. This is to the exclusion of any other task, for example a job in an office. I am not aware of my mouth opening when it decides to happen.

When I have cannabis I can keep my mouth in the normal closed position without any effort whatsoever.

Do you suffer from open mouthed appearance Ann? Can you relate? I was teased for it in school a long time before I smoked cannabis and my cannabis smoking friends noticed I stopped acting weird when I was stoned. That was before I was diagnosed.

It's wrong to suggest that stoned people are any better at tolerating me when I am not stoned. If anything they are more sensitive to the abrasive side of one's autism.

http://www.cell.com/neuron/abstract/S0896-6273(13)00361-9

http://www.cell.com/neuron/abstract/S0896-6273(13)00453-4

http://www.cell.com/neuron/abstract/S0896-6273(13)00225-0

Um, no. These papers are not evidence that cannabis is an effective treatment for autism. I dealt with this particular paper the last time I discussed this issue:

http://scienceblogs.com/insolence/2015/08/06/medical-marijuana-for-auti…

It’s wrong to suggest that stoned people are any better at tolerating me when I am not stoned. If anything they are more sensitive to the abrasive side of one’s autism.

It's also wrong to suggest that I was suggesting it.

...

It's probably futile, since you seem kind of determined not to believe it:

But I swear to you that I was not only not suggesting that, or any other judgmental, harsh, critical thing you care to name, but -- in fact -- not suggesting anything at all beyond what I said.

What I said includes that I think it's great that smoking pot works for you, and that I'm not in a position to know what your experience is apart from what you tell me about it.

Therefore:

When I have cannabis I can keep my mouth in the normal closed position without any effort whatsoever.

I'm happy to hear it. How could I not be?

If you had anything to add, I'd also be both happy and interested to hear it.

Do you suffer from open mouthed appearance Ann? Can you relate?

Forgive me if I'm wrong. But that seems to me more like your way of saying that I couldn't possibly know how you suffer than it does a sincere question. And I don't really see the point of competitive suffering. Seems to me that there's plenty to go around.

So apart from to say that I'm sorry for your suffering, I'm going to take a pass on that.

I was teased for it in school a long time before I smoked cannabis and my cannabis smoking friends noticed I stopped acting weird when I was stoned. That was before I was diagnosed.

That's awful. You deserve better. I'm sorry.

Orac to Greg Carrick RPh: "I dealt with this particular paper the last time I discussed this issue:"

Mr. Carrick, a little hint for you: use the search box near the top of this page before citing a paper. This way you will know if it had been discussed earlier.

@Greg, as our host has noted, not impressive and also how are three citations of mouse studies "plenty" of research to support cannabis use for autistic children?

Good morning Ann! Yes we deserve better, no we don't have that in our offices in the UK. I didn't disclose, they don't know, they can't all be educated because I have to interact with external customers. I have to hide the autism or loose my job, Job hunting with disclosure seriously restricts the jobs you can get.

Perhaps you can relate to this 'symptom' - when listening to people, you find yourself totally avoid eye-contact in order to understand their words, but this can make the other person uncomfortable. If you look at their eyes, your mind spins or freezes or derails onto a different topic or tries to begin formulating a reply instead of listening?
Cannabis alleviates that.

I can relate to that because I can relate to most things by analogy if I try. But I didn't mean to be misleading. I'm not on the spectrum myself.

I have a question, though. To what do you....Hm. Rats. I'm not really sure how to ask this. But what I'm wondering is whether you'd say the cannabis changes the way you act because it changes the way you think and feel, or whether you'd just say it changes the way you act.

That's not a trick question. Cognitive and emotional benefits are real benefits. That's frequently what meds and therapy aim to deliver, in fact. So there are not hidden implications. I'm just wondering how you'd characterize it.

Now we are getting into strange territory and I have no idea how to answer that without leaving the possibility that it is misunderstood.
Can you understand life in terms of mean-time-between-failures?
The cannabis is not making me happy, but it is preventing the unhappiness that comes with repeat failures.
I sometimes decide I can do fine without it. I am always wrong.

I sometimes decide I can do fine without it. I am always wrong.

How are you able to determine that this is not a result of withdrawal? What's the longest you've been abstinent?

Gilbert@129

Yes you are right.For those of us that have this problem,you must avoid all food with folic acid.Eating food with folic acid can cause anything from cognitive problems,to seizures and temporary autistic regression,depending on how much is eaten.Further proof of the gut-brain connection.

AdamG

No it's not the result of withdrawal. It's autism.
Autism is not cannabis withdrawal any more than it is mercury poisoning.

What symptoms of cannabis withdrawal have you personally experienced when you've decided to go without?

Adam G: What percent of children with autism is cannabis effective for? We don’t know. That’s why it should not be approved for this use given the current knowledge base.

Also, I don't believe that the parents who are lobbying for this have their kids' best interests at heart. It seems to me to be just another attempt to turn the kids into lab rats. I wish I had more faith that people could be good parents to autistic kids, but the good, intelligent parents are so few in number!

Esther Knight: Yes we deserve better, no we don’t have that in our offices in the UK. I didn’t disclose, they don’t know, they can’t all be educated because I have to interact with external customers. I have to hide the autism or loose my job, Job hunting with disclosure seriously restricts the jobs you can get.

Doesn't the UK have non-discrimination policies similar to the American Disabilities Act? As far as I know, in the US, you couldn't be fired if you disclosed. You could also maybe request some position that doesn't require being the public face of the company.

As for eye contact, I have a simple trick to avoid it. I'm short, and I never wear heels, so as long as my eyes are in the general vicinity of their face or even their shoulder, I can easily converse with them.

Oh, joy, someone's brought up Wakey's theory.

Can you understand life in terms of mean-time-between-failures?

Yes.

The cannabis is not making me happy, but it is preventing the unhappiness that comes with repeat failures.

Honestly, if there was any drug -- licit or otherwise -- that people could take for happiness, I'd be all for it. But since I'm under the impression that there isn't, I wasn't suggesting that the cannabis made you happy. I just wondered if you had any opinions about how/why it worked.

I sometimes decide I can do fine without it. I am always wrong.

That's a drag. But at least it works.

AdamG the only symptoms of 'cannabis withdrawal' I get are:
- Decreased appetite for two days.
- Increase of tobacco consumption for the duration of cannabis cessation.
- Remembering nocturnal dreams.

Ann my guess on why it works would be to guess that some action on the endocannabinoid system is behind it?

@Esther Knight --

Well...Yes. But that's not really saying a lot. The endocannabinoid system is not implicated in autism. However, that doesn't necessarily mean anything, one way or the other. Low serotonin levels don't cause depression. But taking a pill that boosts them potentially alleviates it for some people for reasons that aren't really clear.

And....That's not really completely analogous, but never mind. Sometimes I just think that the human brain is too complex to be understood by the human brain, tbh. It is by mine, certainly.

So. Be that as it may. I can understand why it pisses you off to read things that appear to invalidate your experience. And I personally have no trouble believing that it's valid and believing that there's no evidence that cannabis has any efficacy for autism, at one and the same time. Because those things can both be true.

But I'm pretty sure that means we just disagree. .

Politicalguineapig--

Yes, the law says that you can't be fired, or refused a job, because of a disability. The problem is enforcement: especially at the job-hunting stage, it's difficult to prove that the reason for not being hired is discrimination, and bringing any kind of lawsuit against a discriminatory employer takes time, energy, and money that the disabled job hunter may not have.

I can't make sense of medical science papers much, but I know for sure I saw one that found that the average autistic person has more cannabis receptors of the second type?
That may be it?

Yes you are right there is no evidence for cannabis being effective in treatment of autism but that surely doesn't necessarily mean that it isn't?

I can't see anything we disagree on so far? Remind me?

E Knight: Believe me, I'm aware of the soulsucking void that is job-hunting. The thing is- you already HAVE a job. Which, I assume has an HR department. So, presumably, you could ask HR if they could arrange a transfer to another department which doesn't force you to interact with the public, which in turn means you don't have to resort to drugs.
Frankly, it sounds to me like your problem is not, in fact, Aspergers, but an anxiety disorder. Which leads us back to our thesis: marijuana might not be the best treatment for autistic people, especially if people are using it as a treatment to deal with the wrong problem.

Anxiety disorders are often found in autistic people. An autistic adult may misidentify the problem, and parents of autistic children generally tune out their verbal kids (or kids who use assistive tech) and won't be able to tell if marijuana is affecting a non-verbal kid, or a kid who can't use technology. And again, like with most 'cures' a marijuana cure would be entirely the decision of the parents, who, are, generally, a gullible lot.

Oh, and I'd like to point out, before the 'you don't know what it's like' card gets played that while I do not have Aspergers, I do have an anxiety disorder, and I'm aware of how much they suck.

Off topic- Orac, could you shut down the trainwreck that is Torquemada's thread? I hate to complain, but it does bad things to my computers.

Hi Pgp, Vicki is right and so are you. There are laws, the laws do nothing for us. No we don't have an HR dept or even a dedicated HR manager.
I personally don't suffer from anxiety so if that answers your question?

What cannabis most certainly does not do, is give us that spooky telepathic kind of emotional mind-reading that non-autistics take for granted. While it may make it easier for us to calmly observe others, we still have to try to deduce the meaning of body language consciously all the time.
Another thing it does not do is give us that ability to remember lots of things about other people that non-autistics take for granted.

I can’t make sense of medical science papers much, but I know for sure I saw one that found that the average autistic person has more cannabis receptors of the second type?
That may be it?

You're right that there is such a paper. And I can't really follow all the twists and turns in it either.

But fwiw, it's my understanding that findings of that kind in small samples are almost always very tentative because there's so much natural individual variation that nobody really knows what "normal" is -- ie, if you tested the CB2 levels in lots of people with and without autism, you'd get a number cross-overs in both directions.

Still. A finding is a finding. You're right.

I can’t see anything we disagree on so far?

Maybe we don't. I take it back.

While it may make it easier for us to calmly observe others, we still have to try to deduce the meaning of body language consciously all the time.
Another thing it does not do is give us that ability to remember lots of things about other people that non-autistics take for granted.

I don't know if you'd like CBT, or find it useful. Or interesting. Or if it's even an available option in some reasonably tolerable form where you are, ftm. But I think you'd be good at it.

Forgive me if that's presumptuous. You know yourself, and I don't. Obviously.

Esther Knight: How do you know the laws don't apply to you? Or that you can't talk to someone about making your work life a bit more pleasant?

And for someone who says she doesn't have anxiety, you put a lot of emphasis on how you appear to other people, to the point of needing a mind-altering substance to cope with day to day life.

Social skills aren't a 'spooky telepathic kind of emotional mind-reading.' They're learned reactions, nothing more. Again, not autistic, but I had to learn everything for myself and hide the process from people, so I do understand your reaction.
But really, same-gender interactions aren't all that complicated- most people just want a set of sympathetic ears in their life. And, by your own admission, you have friends and a significant other, so I think you're a lot better at socializing than you think you are.

I haven't been able to read all of the comments posted yet, but @24 and @25, Just because a mother is researching the effects of cannabis doesn't mean she is shameful of her child and wants to dope them up!!!! How dare you. I am researching to improve his quality of life. I have been to doctors all over the state of Ohio, not being able to pin point what is wrong with my child. I have tried behavioral therapy, had behavioral specialists in my home. My son has multiple diagnosis, Cerebral Palsy, Epilepsy, Autism, and Bi Polar disorder, and as his mother I am not even sure of the Bipolar, he has had genetic testing, and I was a mother who said she would never put her child on medicine, but now he takes 5. He was verbal until he was 3, now he only says a handful of words. It is like my child left. I want to help my child's quality of life, before meds he would have episodes of staying awake for 5 days straight, and I guess I just want to dope him up so I don't have to deal? I guess it has nothing to do with his well being? Have you ever stayed awake for 5 days? I give him meds to help him too, not to dope him up. During these days his heart would race, eyes dilate, black circles around his eyes. How dare you say something like parents just want to dope their kids up so they don't have to deal. I am just looking for ways to improve his quality of life. Not sure if I would ever do cannabis, but meds make him tremble, not eat, now he sleeps at school. So if there is a chance to research something, I try to educate myself to see if there are better possibilities for his quality of life.

@Orac,

You are correct that there is a significant dearth in scientific evidence for the therapeutic efficacy of marijuana in treating autism. Why? Scientific research is always guided by sociopolitical forces. Pro-lifers were successful in holding back embryonic stem cell research in the U.S. until recently, but it has set back research considerably.
Regarding research into the link between cannabinoids and autism, it is scientific researchers who are holding back the research, because they refuse to do it. This is probably because they're biased to believe marijuana cannot attenuate symptoms of autism, or if it can, the negative side-effects outweigh the good. What better incentive could there be for researchers to start taking interest, if there are parents out there who are giving their autistic children marijuana on a regular basis without knowing the potential harm?

As for the anecdotal accounts online from parents of autistic children, there are three points to consider:

1.) In all the accounts I've read, the parents detailed everything they have tried before resorting to giving their child marijuana. Since it's anecdotal evidence posted online, it could all be lies. But if they were all being honest, it would indicate the parents have nothing but the best intentions for their children's safety.

2.) The resources available for autistic children are usually very expensive, leaving out many who come from poor families. It's not surprising then for parents to give their child marijuana to calm him/her down, instead of paying a therapist $300 an hour for behavioral training or use expensive pharmaceuticals, which may not produce any significant changes in the child's anxiety, or it could make things even worse.

3.) We allow physicians and psychiatrists to prescribe antidepressants and stimulants for autistic children, as autism is typically comorbid with other mental-health conditions. Are they going off of extensive scientific research when they prescribe a medication to an autistic child? Or are they taking anecdotal suggestions from their colleagues or from what they read online?

In short, parents of autistic children feel they are completely on their own. I do agree that they shouldn't put their blind faith into marijuana. But if no one wants to do the research, and there are autistic children who are still suffering crippling anxiety and commit self-harm, even after extensive behavioral therapies, using potentially hazardous pharmaceuticals prescribed off-label, or have tried several special diets, are the parents to do nothing but keep plugging away with therapies that pass public consent, and hope for something good over time?

it is scientific researchers who are holding back the research, because they refuse to do it.

Do you have any evidence for this aside from your own feelings?

@AdamG

There is a lack of research into palliative treatments for autistic people alive today. Most research on autism is only concerned with either preventing or curing it.

There is still a stigma attached to marijuana in the scientific world; scientists are not imperturbable to societal influences.

@AdamG

For what it's worth, I did a quick google scholar search for "cannabis+autism," and all I found were studies on the prevalence of drug abuse in autistic teens and adults, nothing focused on autism and cannabis. I couldn't even find one study about any palliative treatment for symptomatic relief of autism: it's all about preventing or curing it.

The lack of studies, is evidence that researchers refuse to touch the subject.

Eric @173: In the United States it is generally illegal to do research with marijuana because it is a schedule I drug. No university would dare try to do research for fear of losing all federal funding. Researchers who want to do marijuana research must petition the ATF, and permission is rarely granted.

If you want the research done, don't complain to researchers who can't do it, complain to the "War on Drugs" that won't let them do it.

Also, it is only the "cranks" who are pursuing "curing" autism - the real research being conducted is primarily focused on helping those with autism better cope with the symptoms of their condition.

@AdamG

Ok I just found a review published this year (link to abstract below, full article available as PDF), and the conclusion fits with my premise: there is not enough research to officially condone using marijuana to treat developmental disorders like autism, but there are enough anecdotal accounts to strongly suggest that marijuana as a therapy should not be ruled out.

"Given the current scarcity of data, cannabis cannot be
safely recommended for the treatment of developmental
or behavioral disorders at this time. At best, some might
consider its use as a last-line therapy when all other conventional therapies have failed."

For some autistic children, no conventional therapy has helped them.

http://journals.lww.com/jrnldbp/Abstract/2015/02000/Medical_Marijuana__…

there is not enough research to officially condone using marijuana to treat developmental disorders like autism, but there are enough anecdotal accounts to strongly suggest that marijuana as a therapy should not be ruled out.

So then what is your specific disagreement with what Orac wrote?

@JustaTech

You're right that there are huge legal obstacles preventing researchers from procuring grants to research marijuana for any therapeutic application. But the only way to change those laws is if the public agrees to it, and the only way that will happen is if more researchers take the risk and apply for federal grants. People would read about it in the news, which would then start a public discussion on using marijuana to treat developmental disorders. The public doesn't even know they have an Endocannabinoid System, something we discovered in 1990. How else are they going to learn about the medical research, if researchers don't ruffle a few feathers?

@AdamG

My specific disagreement with Orac's argument, is we shouldn't bar parents with autistic children to try cannabis after they've tried everything else, just because there is a lack of scientific evidence.

*grammar corrrection

My specific disagreement with Orac's argument, is we shouldn't bar parents from giving cannabis to their autistic children after they've tried everything else, just because there is a lack of scientific evidence.

I guess you'd also agree with the statement - "we shouldn't car parents from giving their children Lupron, Industrial Chelation Agents or Bleach to their autistic children, after they've tried everything else, just because there is a lack of scientific evidence."

sorry - "stop parents."

I said the Endocannabinoid System was discovered in 1990, but that's only part of the story: cannabis receptors were discovered in 1990, but it was in 1992 when anandamide, an endocannabinoid, was discovered.

http://www.beyondthc.com/wp-content/uploads/2012/07/eCBSystemLee.pdf

Eric @179: There is a huge difference between "ruffling a few feathers" and shutting down the entire University of California system.

Yes, I agree that a lot more research needs to be done and the feds need to stop restricting researchers this way.

But you should know it could likely be decades before any results of that research makes its way into practice. Or the research may show that marijuana and marijuana-derivatives have no beneficial impact on children or adults with autism.

we shouldn’t bar parents with autistic children to try cannabis after they’ve tried everything else, just because there is a lack of scientific evidence.

Why?

@Lawrence

All the more reason for scientists to step in and investigate the matter in order to establish what works and what doesn't work.

I agree that parents shouldn't try just anything. There may not be enough research yet to show marijuana is safe for autistic people, but there is enough data on the functions of the Endocannabinoid System, and the therapeutic effects of phytocannabinoids, to strongly suggest the Endocannabinoid System could be a potential target for palliative treatment.

Those quackery-treatments you juxtaposed with marijuana have no supporting data whatsoever to suggest they do anything.

And yet, really neither does giving cannabis to autistic children either....

@AdamG

Two reasons why:

1.) For some parents, cannabis is the only thing which seems to calm their child down, and make them want to engage and bond with others. The same is true with autistic adults, as they are trying cannabis as well. There are mixed results all around, and some do experience paranoia. We should be researching why some benefit from cannabis and others don't, and allow those who do benefit, to continue taking it.

2.) Unlike the quackery treatments like bleaching or using Lupron or chelation-agents, there is actual scientific evidence connecting symptoms of autism with a deficient Endocannabinoid System, which is more than the aforementioned quackery can offer.

It is a risk, let's be clear, when parents decide to give their autistic child marijuana. But for those who have, and have had good results, we weren't there when their child held eye contact with them for the first time in the child's life, or became calm enough to be comfortable with being touched, even wanting to reach out and give affection to others.

Yes it is a knee-jerk reaction when parents decide to try marijuana, if it's because they read personal accounts from other parents online. But there are a lot of personal accounts, written in great detail, and they all seem to have the same experiences: their autistic children are more relaxed, more willing to engage in imaginative play, are more comfortable with holding eye contact and carrying a conversation, can eat again, and generally wish to socially engage people more often than they had before they tried cannabis.

@JustaTech

Researchers are presented with a Catch-22 then: they aren't allowed to research marijuana because it's considered a harmful drug, but in order for it to be considered safe, it has to be verified through scientific studies. I agree that researchers who wish to study marijuana, and I'm sure there are some out there, are faced with an unfair situation.

If research does eventually show marijuana is harmful, even for those who gain benefit from it, I'll be glad to learn it. Ruling out ineffective treatments only brings us closer to effective treatments.

Eric--

A few thoughts: the first is that if you want to lobby, talk to either President Obama or current presidential candidates about taking marijuana off schedule 1.

Second, the world is larger than the United States, and most of the world's population lives outside North America; what research into marijuana for people with autism is going on elsewhere? (Maybe someone should set up a research institute in Uruguay.)

Third, there are a lot of adults with autism. An autistic adult trying marijuana to help them deal with symptoms is a different question, ethically, from a parent giving it to an autistic child. (The things you're talking about, like problems with social interactions, don't magically fix themselves on a person's 18th birthday.)

@Vicki

Marijuana should definitely be taken off Schedule 1. One of the major obstacles I see standing in the way is the insurance industry: no doubt they'll lobby to keep it a schedule 1 drug, because they don't want to cover work/home injuries or medical problems if marijuana is involved, like they have to with alcohol-related incidences.

There probably are studies underway outside the U.S. Marijuana is being studied as a treatment for other mental-health conditions as well, which will undoubtedly provide insights as to why manipulating the Endocannabinoid System with cannabis, has an effect on symptoms of autism.

I should have mentioned earlier I'm a high-functioning autistic myself. You're right about the social difficulties not magically disappearing after I turned 18. I'm 29 now and I've been vaping cannabis oil on a regular basis since spring. Conceptualizing general concepts is much easier now than before I started, background noises are tolerable, and it's easier to let go of ruminating thoughts. Personally, it's better than a cure: it helps me enjoy life as I am!

I know not all autistics can benefit from marijuana, but I've read enough personal accounts online to be convinced there's at least a pattern. Correlation≠causation, I know, and I'm willing to admit I could be doing more harm than good to myself in the long term.

At least I'm avoiding the carcinogens.

Lawrence @176

I'm sure there are studies underway focused on treating symptoms. It's frustrating the research is so slow though, and I wonder if part of this is because we still don't have a unifying theory on what the pathophysiology of autism is. Risperidone and Aripiprazole are currently the only two medications approved for ASD, but it only treats irritability.

Marijuana should definitely be taken off Schedule 1. One of the major obstacles I see standing in the way is the insurance industry: no doubt they’ll lobby to keep it a schedule 1 drug, because they don’t want to cover work/home injuries or medical problems if marijuana is involved, like they have to with alcohol-related incidences.

You think that workers' comp covers on-the-job injuries caused by being drunk? For that matter, a quick check suggests that fewer states prohibit health insurers from denying claims based on the presence of alcohol in one's system than those that explicitly allow it.

Researchers are presented with a Catch-22 then: they aren’t allowed to research marijuana because it’s considered a harmful drug, but in order for it to be considered safe, it has to be verified through scientific studies.

ORLY?

@Orac

I forgot to address two of your chief complaints about the Michigan initiative: no defining guidelines on dosage, and no measure of marijuana toxicity. Parents giving their autistic children marijuana, typically give them a tincture to dissolve underneath their tongue. This is one of the most precise and easiest methods to measure out doses, by the milligram. As with Adderall and Ritalin, the dosage needed depends on the individual. There is a limit to how much THC is needed before it impairs their ability to function, but again, this limit largely depends on the individual. If, however, the strain used has a high Cannabidiol (CBD) content, the CBD actually treats the negative side-effects of THC*. Research so far has shown CBD taken by itself presents no danger of toxicity, even after acute, long-term administration (the combination of CBD/THC taken in the long term hasn't had a lot of attention, but it's being studied now).

As far as toxicity, it's still undecided if THC can actually damage the developing brain. Evidence strongly suggests it can impact those genetically predisposed to schizophrenia. But no one has concluded THC causes any lasting or permanent brain damage, even for chronic users who started early and later developed schizophrenia. For those who do develop bad side effects from THC, they could take a smaller dose if they still derive benefits from it, or just take Cannabidiol if THC stops working.

One major difference between this and prescribing children conventional pharmaceuticals, which is a stark contrast, is the absence of a physician to monitor and guide the administration of marijuana. I agree we need more research done. But in the meantime, these parents will most likely not stop giving their children marijuana, even if it remains illegal for them to do so. If the Michigan initiative had passed, families would have been more inclined to seek out professional medical advice, and fewer of them would be keeping their child's treatment a secret. This secrecy, no matter how it's looked at, is a major problem, and I believe the benefits of transparency trumps the potential unknown risks yet to be discovered.

*http://dmd.aspetjournals.org/content/23/8/825.short

the CBD actually treats the negative side-effects of THC

See Eric, this is why I can't stand people who have fooled themselves into thinking marijuana is anything other than recreational fun. That's not a bad thing...I use regularly recreationally and support full legalization. But which part of the study you cited has anything to do with treating negative side effects in patients?

Here's an exercise in skepticism for you. How do the concentrations of THC and CBD used in the study you cited compare to what's observed in humans after marijuana consumption?

Eric,

Did you happen to read that particular comment of mine:

http://scienceblogs.com/insolence/2015/08/06/medical-marijuana-for-auti…

Did it occur to you that marijuana is more harmful to me (and yes, the comment I made is about myself first, other autistics too) as compared to the prescription meds who saved my life. Do you know about the hypocratic sermon?? The one for which all the medical doctors supervising my health status are bound to obey wouldn't condone using marijuana because there is not enough data about its benefit while the harm I and others autistics have endured made them sure that they will never prescribe marijuana until there's better evidence that it doesn't cause cardiac and/or anxiety issue in their patients and the benefits outweigh the harms. Now do you get this picture or I have to use stronger language to insert these concern in your brain???

Alain